[Factors facilitating development of degenerative aortic valvular stenosis].

The aim of the study was to determine factors of risk and progress of aortal valvular calcinosis (AVC) and aortic ostium stenosis (AOS). The subjects were 85 patients with AVC (42--with aortic valvular stenosis (AVS), and 43--without AOS). The study, which included analysis of the lipid and mineral metabolism, and immunological tests, shows that potential factors of AVC are: age (p < 0. 001), osteoporosis (p < 0.03), mitral ring calcification (p = 0.047), dislipidemia (high serum level of total cholesterol, cholesterol of low density lipoproteins, and apoB, atherogenic shift of apoB/apoA-1 ratio, low level of cholesterol of high density lipoproteins (CHDLP)), disbalance between intecellular matrix synthesis and destruction (high concentration of alkaline phosphatase and its bone fraction, and accelerated deoxypyridinoline excretion), inflammation (high concentration of C-reactive protein (CRP), fibrinogen, and interleukin-6 (IL-6)). The factors of AOS were: age (p < 0.001), smoking (p < 0.001), osteoporosis (p = 0.004), AVC (p < 0.001), mitral ring calcinosis (p = 0.033), dislipidemia (high levels of cholesterol of low density and very low density lipoproteins, low concentrations of CHDLP, and apoA-1), degradation of extracellular matrix, and inflammation (high concentrations of CRP, fibrinogen, IL-6, and IL-8). Thus, atherogenic dislipidemia and mineral dysmetabolism disorder facilitate AVC. The revealed immune status changes imply the role of inflammation in the development and progress of AVS.

["Function-corrected" indexes for precise estimation of aortic stenosis severety].

The aim of the research was to study clinical significance of "function-corrected" indexes (FCI) in non-invasive evaluation of aortic valvular stenosis (AVS) severity. 85 patients with degenerative aortic valve calcification (42 - with AVS and 43 - without aortic ostium (AO) stenosis) were subjects of a cross-sectional study. Significant correlation between AO area and FCI indexes was demonstrated. When it is not possible to determine AO by planimetric methods, it may be counted using FCI with good sensitivity (87%) and specificity (94%).

[Current technologies for enhancing efficiency of laboratory techniques]. / Sovremennye tekhnologii povysheniia éffektivnosti ispol'zovaniia vozmozhnostei laboratorii.

The current approaches to promoting the efficiency of applying the laboratory tools were comprehensively analyzed. It was for the first time that the above issue was considered from the standpoint of a scientifically substantiated management scheme applicable to the laboratory examination volume and within the framework of the modern conclusive medicine. The problem can be solved through starting, in each clinic, an independent research project and through patient management (critical course--technological card) with respect to available technological and personnel resources. Finally, the basic principles are outlined that are needed for designing the technological cards; the related role of experts in clinical laboratory diagnostics is demonstrated.

[Aortic valve stenosis: persistence of infective agents or noninfective inflammatory process?]. / Aortal'nyi klapannyi stenoz: rezul'tat infektsionnoi agressii ili neinfektsionnoe vospalenie?

The probable risk factors leading to aortic valve calcification are not clearly defined. The cross-sectional study of 85 patients with vascular and valvular calcification was performed. Correlations between the immune tests and aortic stenosis severity were investigated. The predictors of aortic valve calcification were probably C-reactive protein and interleukin-6. The predictors of aortic stenosis progression were interleukin-8, antibodies of Chlamydia pneumoniae and cytomegalovirus, and dysregulation of complement's components. Implication of immune reactivity could influence aortic valve calcification.

[Physiological valvular regurgitation in healthy persons (its prevalence, hemodynamic characteristics and differential diagnosis)]. / Fiziologicheskaia klapannaia regurgitatsiia u zdorovykh liudei (rasprostranennost', gemodinamicheskaia kharakteristika, differentsial'nyi diagnoz).

Two-dimensional Doppler echocardiography (DECG) was employed to examine for valvular regurgitation 100 healthy subjects. Physiological valvular regurgitation (PVR) was detected in 32 of them. It was defined as isolated pulmonary, isolated tricuspid, combined tricuspid and pulmonary, mitral in 17%, 9%, 4% and 2% of the examinees, respectively. Hemodynamically, PVR was characterized by low maximal speed of the flow and minimal extension. It should be noted that similar hemodynamic DECG parameters can be registered in minimal aphonic valvular regurgitation arising in latent rheumatic and viral endocarditides. This fact must be taken into consideration when making the differential diagnosis.

[The assessment of left ventricular diastolic function in patients with aortic defects]. / Otsenka diastolicheskoi funktsii levogo zheludochka u bol'nykh s aortal'nymi porokami.

Thirty patients with aortic heart disease and 10 healthy persons were examined for diastolic function of the left ventricle using two-dimensional Doppler echocardiography. The decline of the rate and volume of early diastolic filling, the rise of the filling during the atrial systole were revealed in 60% of the patients with aortal disease. The decrease of the ejection fraction of the left ventricle was noted in 23.3% of the patients. All the patients with aortic disease were distributed into 2 groups depending on the presence (group II) or lack (group I) of mitral regurgitation. Addition of mitral regurgitation in patients with aortic disease masked the deranged filling of the left ventricle and interfered with the diagnosis of diastolic dysfunction. A reverse moderately pronounced relationship (r = -0.56) has been discovered between the myocardial mass and impairment of the diastolic filling.

[Infectious endocarditis in hypertrophic cardiomyopathy]. / Infektsionnyi éndokardit pri gipertroficheskoi kardiomiopatii.

The authors describe 2 cases of infectious endocarditis in patients with idiopathic hypertrophic subaortic stenosis. In one case, the disease eventuated in lethal outcome. Photomicrographs of histological preparations are provided.